The present invention relates to medical equipment and has particular reference to surgical instruments for stitching up soft tissues; the instrument may be applied predominantly for suturing thick-walled organs, e.g., the walls of the left ventricle of the heart or of the liver, with lengths of spiked suture material which may be a metal or a dissolvable matter.
A surgical instrument for stitching up soft tissues with lengths of spiked suture material is known (cf. an earlier filed application by the same inventor, having a Convention priority date of Mar. 11, 1977), said instrument comprising a hollow body which houses a tubular needle having a through bore adapted to accommodate a length of spiked suture material to be introduced into the tissue being sutured along with the needle, and a stop stationary with respect to the body and accommodated inside the through bore of the needle. The needle is mounted slidably along the stop so as to retain the length of suture material in the tissue being stitched while extracting the needle therefrom. In addition, the needle has a drive to move along the stop, said drive being defined by a cylindrical rod running inside the body so as to envelope the stem carrying the stop, said rod terminating at one of its ends in a handgrip, while the other end thereof has a tapered hole adapted to engage a tapered sleeve serving for a detachable mounting of the needle at the rod end.
The afore-discussed surgical instrument for stitching up soft tissues with lengths of spiked suture material operates as follows.
The tapered sleeve of the tubular needle with a length of suture material is fitted into the tapered hole of the cylindrical rod of the instrument to make the latter ready for operation. Then, the needle is pricked at the juxtaposed lips of the wound in a soft tissue in such a manner that the needle should pass through both of the wound lips. Next, with the body of the instrument not withdrawn from the surface of the tissue being sutured, one must retract the handgrip of the instrument upwards, thus causing the needle to slide along the stop to be extracted from the tissue, whereas the stop and the length of suture material thrusting thereagainst remain immobile, and the length of suture material is left in the tissue, thus holding together the wound margins. This done, the instrument is withdrawn from the thus-established suture. To apply a next suture, the used-up needle is replaced by the one charged with suture material.
The afore-described known instrument is capable of suturing soft tissues of any thickness throughout the depth of incision, which adds to the regeneration rate of the tissues lying in the plane of incision in deeply seated wounds due to an improved contact of the dissected tissues being sutured. However, the instrument proves to be inapplicable in cases where some vital blood, vessels, ducts, or nerves run nearby the wound margin (e.g., when the margin of the wound on the heart lied close to the coronary artery) this being accounted for by the fact that said instrument is applicable for suturing deeply seated wounds only when rather long distances from the wound margin to the point of the needle introduction into the tissue are available, since the needle should make up an angle with the wound incision, the thicker the tissue being sutured the longer the above distance.